Text: S03584 Text: S03586 Text: S03500 - S03599 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend House File 715, as amended, passed, and 1 2 reprinted by the House, as follows: 1 3 #1. Page 57, by inserting after line 22 the 1 4 following: 1 5 "Sec. . NEW SECTION. 217.13A PHARMACEUTICAL 1 6 ASSISTANCE PROGRAM ESTABLISHED. 1 7 1. For the purposes of this section, unless the 1 8 context otherwise requires: 1 9 a. "Eligible person" means a person, sixty-five 1 10 years of age or older with an annual net income of not 1 11 more than one hundred fifty percent of the federal 1 12 poverty level, as defined by the most recent poverty 1 13 income guidelines published by the United States 1 14 department of health and human services, or a person 1 15 sixty-five years of age or older, who with the 1 16 person's spouse has an annual net income of not more 1 17 than one hundred fifty percent of the federal poverty 1 18 level, as defined by the most recent poverty income 1 19 guidelines published by the United States department 1 20 of health and human services. "Eligible person" does 1 21 not include a person who is eligible for financial 1 22 assistance for the purchase of prescription drugs 1 23 under another local, state, or federal program to the 1 24 extent that the other program provides financial 1 25 assistance for the purchase of prescription drugs. 1 26 b. "Prescription drug" means a prescription drug 1 27 as defined in section 155A.3. 1 28 c. "Program" means the pharmaceutical assistance 1 29 program established in this section. 1 30 d. "Reasonable cost" means a charge which is equal 1 31 to the average wholesale cost of the prescription drug 1 32 and the additional dispensing pharmacy's usual fee, 1 33 not to exceed the seventy-fifth percentile of usual 1 34 and customary fees in this state, as determined by the 1 35 Iowa department of public health. 1 36 2. A pharmaceutical assistance program is created 1 37 within the department to provide for subsidization of 1 38 the prescription drug costs of eligible persons in 1 39 rural and urban areas throughout the state. The 1 40 director shall appoint an advisory committee to make 1 41 recommendations to the council in the creation of the 1 42 program and in adoption of rules to implement the 1 43 program. The Iowa pharmaceutical association shall 1 44 assist the council in the creation and implementation 1 45 of the program. 1 46 3. The council shall adopt rules to implement this 1 47 section. The rules shall provide for all of the 1 48 following: 1 49 a. A means to determine the eligibility of a 1 50 person, including proof of the person's actual and 2 1 anticipated annual net income, evidence of complete or 2 2 partial payment for the costs of prescription drugs 2 3 from a provider other than the program, and other 2 4 provisions consistent with this section. 2 5 b. Issuance by the department of a participation 2 6 card upon approval of an application. The annual fee 2 7 for participation in the program is eighty dollars. 2 8 An initial application shall be accompanied by proof 2 9 of the date of birth of the person. 2 10 c. A prescription copayment of twenty percent of 2 11 the reasonable cost of the prescription which shall be 2 12 collected from the person participating in the program 2 13 by the dispensing pharmacy not to exceed eight hundred 2 14 dollars in prescription costs for each calendar year. 2 15 Thereafter, a copayment of forty percent of the 2 16 reasonable cost of prescriptions in excess of eight 2 17 hundred dollars for the remainder of any calendar year 2 18 shall be collected. The balance of the reasonable 2 19 costs shall be paid by the department to the 2 20 dispensing pharmacy after submission of a claim to the 2 21 department. 2 22 d. A provision that if the cost of the 2 23 prescription drug exceeds the reasonable cost and the 2 24 prescription drug is available under a generic name, 2 25 the eligible person may obtain the trade name drug 2 26 rather than the generic drug by paying the difference 2 27 in the amounts of the trade name drug and generic name 2 28 drug. However, if the prescribing practitioner 2 29 indicates on the prescription that a substitution of 2 30 the trade name drug is prohibited, the eligible person 2 31 is subject only to payment of the copayment amount. 2 32 e. A reimbursement system which includes on-line 2 33 point of service claims transmission and adjudication, 2 34 with utilization review. 2 35 f. A form of identification for persons to use in 2 36 proving eligibility. The form of identification shall 2 37 include a conspicuous notation of the penalties for 2 38 violation of this section. 2 39 g. A requirement that prescriptions contain the 2 40 name, address, and identification number of the 2 41 eligible person. 2 42 h. A provision to ensure choice of pharmaceutical 2 43 services by the eligible person. 2 44 4. A person who supplies false information to 2 45 establish eligibility for the program or to obtain 2 46 reimbursement is guilty of a serious misdemeanor." 2 47 #2. By renumbering as necessary. 2 48 2 49 2 50 3 1 PATRICIA HARPER 3 2 STEVEN D. HANSEN 3 3 3 4 3 5 3 6 ROD HALVORSON 3 7 HF 715.318 77 3 8 pf/cf/28
Text: S03584 Text: S03586 Text: S03500 - S03599 Text: S Index Bills and Amendments: General Index Bill History: General Index
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